Smoking and Nurses in NEW ZEALAND - ASH

that is primarily responsible for smoking related illness. This belief could be a barrier for the use of effectivesmoking cessation medications like nicotine replacement therapy. In fact nicotine is responsible for addictionand it is products of combustion that have greatest risk for disease (Royal College of Physicians of London,2000; World Health Organisation, 1986)). Nurses, as well as other healthcare professionals and smokers,would benefit from information about the role of nicotine.Nurses were keen to refer to smoking cessation specialists when needed. Of the nurses surveyed theywere most likely to refer people who smoke to the Quitline. This is similar to an Australian survey where thetelephone based smoking cessation services are most widely promoted (Nagle et al, 1999). They were lesslikely to refer to some of the specialist smoking cessation programmes, and many were not aware of theexistence of these. Knowledge of these programmes could enhance service to clients. For instance, AukatiKai Paipa offers a kaupapa Maori service reflecting Maori culture and identity.In addition, knowledge of effective smoking cessation treatments could be improved. Like most smokers,nurses were more likely to know of nicotine patches and gum for smoking cessation than medications suchas nicotine inhaler or nortriptyline. Treatments such as hypnosis and acupuncture were identified as effectivetreatments by more than a quarter of nurses. These treatments are often well advertised, but there is noevidence for these treatments in helping people to stop long-term (Abbot et al, 2006; White et al, 2006).Nicobrevin was also selected by a third of nurses as being effective. There is currently insufficient evidenceavailable to determine the effectiveness of this treatment and so it should not be recommended to smokers(Stead & Lancaster, 2006). This data confirms that further smoking cessation training should be readilyaccessible for nurses.Ideally all nurses should receive basic training to address the gaps in knowledge described above. Basictraining would equip them with some knowledge on tobacco dependence and smoking cessation, how toprovide brief advice, and what smoking cessation services are available to people who want help in quitting.It is important that it is consistent with the evidence-based national guidelines for smoking cessationinterventions (Ministry of Health, 2007). Training needs to include information about work with prioritypopulations – Maori, Pacific Island peoples, pregnant women and people who use mental health andaddiction services. Brief intervention training is delivered in some undergraduate nursing courses in NewZealand and this should be expanded (Smoking Cessation Training Framework Advisory Group, 2007).In new-graduate and post-graduate settings training can to be tailored to the special populations nurseswork with. Advanced training should also be made available for nurses so they can provide treatment.Support and education for nurse assistants and enrolled nurses is important.ASH-KAN AOTEAROA: ASSESSMENT OF SMOKING HISTORY, KNOWLEDGE AND ATTITUDES OF NURSES IN NEW ZEALAND 27